并发急性脑积水的颅内前循环动脉瘤的早期显微手术治疗  

Early Microsurgery for Aneurysmal Subarachnoid Hemorrhage with Acute Hydrocephalus

作　　者：谭海斌[1] 黄光富[1] 李志立[1] 王振宇[1] 刘进平[1] 

机构地区：[1]四川省人民医院神经外科,四川成都610072

出　　处：《四川医学》2014年第5期558-560,共3页Sichuan Medical Journal

摘　　要：目的探讨颅内动脉瘤破裂合并急性脑积水早期显微手术的可能性和治疗效果。方法回顾性分析2010年8月至2012年6月四川省人民医院神经外科收治316例动脉瘤性蛛网膜下隙出血中并发急性脑积水的70例患者。比较不同手术期别术后1个月GOS评分。结果早期组术后恢复良好28例、差8例、死亡2例。晚期组术后恢复良好9例、差16例、死亡3例。术后1月GOS评分进行Ridit分析:早期手术组治疗效果优于晚期手术组。结论颅内动脉瘤破裂合并急性脑积水早期手术可以避免动脉瘤再破裂,同时处理脑积水,减轻神经功能持续损害,取得较好预后。Objective To study the therapeutic effect and possibility of the early surgery for aneurysmal subarachnoid hemorrhage with acute hydrocephalus.Methods Retrospectively analyzed the data of 70 cases of ruptured intracranial aneurysm with acute hydrocephalus among 316 patients with aneurysmal subarachnoid hemorrhage admitted in our hospital between August 2010 and June 2012.The clinical outcomes were evaluated by Glasgow Outcome Scores（GOS） postoperatively 1 month.Results The Ridit analysis of GOS 1 month after the surgery revealed that the outcome was better in early surgery group than that in late clipping group,no matter the Hunt-Hess grade was high or low.Conclusion The early surgery can avoid rebleeding of intracranial aneurysm,therefore,should be considered in the treatment of intracranial aneurysms with acute hydrocephalus,and may result in improved outcomes.

关 键 词：蛛网膜下隙出血 颅内动脉瘤 脑积水 显微手术 

分 类 号：R651.11[医药卫生—外科学]